Vaginal Cancer

Treatment

Radiation Therapy

High levels of radiation (many times greater than X-ray levels) can be used to treat vaginal cancer. Special equipment is used to aim radiation at tumors and/or diseased tissue. Pelvic radiation often consists of a combination of internal and external radiation.

Internal radiation treatment (brachytherapy) involves placing tiny radioactive devices into the vagina. Several methods of brachytherapy are used:

• Intracavitary — A cylinder like device is placed in the vagina. Radioactive material is then put into the device and delivered in high doses directly to the vaginal tumor.
• Interstitial — Needles are placed into the tumor through the perineum (region between the vulva and anus). Radioactive material is then fed through the needles into the tumor. Mayo Clinic is one of a few centers in the United States that offers this innovative treatment.

Brachytherapy allows for high dosages of radiation that can shorten the treatment time and reduce the need for hospitalization.

Surgical Treatment

For some early stage vaginal cancers, surgical excision is the treatment of choice. Unfortunately, most tumors have advanced beyond this early stage at the time they are diagnosed. The close proximity of the bladder and rectum to the vagina makes surgical resection difficult without removing those organs. This makes radiation therapy preferable in many cases. However, depending on location, some tumors may be treated surgically while still preserving these organs.

Reconstructive Surgery

At Mayo Clinic, a gynecologic oncologist and a plastic surgeon work as a team to produce results that restore as much anatomy and function as possible. This teamwork is especially important for some vaginal cancer cases, in which surgical reconstruction is necessary to the treatment plan. Surgeons provide a full range of reconstructive surgery procedures, including:

• Rebuilding the vagina after radical cancer treatment
• Using skin grafts to cover large defects caused by radiation therapy or radical surgery for recurrent cancer in the vulva and groin
• Rebuilding vital organs, such as a urinary bladder, vagina or pelvic floor, that were removed to treat advanced cancer or were badly damaged during radiation therapy. In bladder reconstruction, for example, it is often possible to create a pouch that holds the urine internally, eliminating the need for an external collection bag.
• Reconstruction of the pelvic floor to correct pelvic prolapse and urinary or rectal incontinence

Physicians and staff members spend time with patients to discuss their concerns and expectations and review treatment and reconstruction. Reconstructive surgery techniques at Mayo Clinic can produce cosmetically pleasing and functional results that improve a woman's quality of life.